[Hazards of pelvic radiotherapy].
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Biomedical subjects
Publications and source records attributed to F Eschwege.
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The first part of the study was devoted to 199 tumors treated by surgery, either conservative for the smallest tumors (18 cases) or radical (181 cases), with systematic postoperative radiotherapy. The 3-year survival rate was 48% and the 5-year, 33%, with a 12% local recurrence rate, a 7.5% neck recurrence rate, and 27.6% rate distant metastases. Histologic correlations were developed. The second part of the study reported 152 cases treated by external radiotherapy alone either as a variant of our treatment protocol for the small-sized tumors (31 cases) or, for the major part (121 cases), as a result of surgical inoperability or patient refusal. The former subgroup had a variable survival rate (65% at 3 years and 40% at 5 years) equivalent to similarly staged patients treated with conservation laryngeal surgery, whereas the prognosis of the latter subgroup was poor. The two main causes of failure were the inability to apply the curative treatment protocol in 35% of patients ineligible for a surgery and the high risk of distant metastases in the 65% of patients able to undergo the usual management.
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PURPOSE: Retrospective analysis of the results of radiotherapy in localized prostatic adenocarcinoma. Complications were excluded. PATIENTS AND METHODS: Six-hundred-and-ten T1-T2 adenocarcinomas of the prostate were treated with continuous courses of external beam radiation therapy in 19 participating Institutes between January 1983 and January 1988. The mean follow-up was 10.4 years; the mean age of patients at the beginning of radiotherapy was 68.5 years. RESULTS: A 10-year, local control had been achieved in 86% of T1-T2 (81.4% for T2). The 5- and 10-year metastatic relapse rates were 25.3% and 30% (29% and 38.1% for T2), respectively. At 10 years, 62.4% of T1-T2 were recurrence-free; overall survival rate was 45.8% and cause-specific survival rate was 70.5%; 29.9% of T1-T2 patients were alive and disease-free. T category (TNM), pathologic grade, pelvic lymph node status, local tumor control, and obstructive ureteral symptoms were correlated with survival. The influence of pelvic nodes radiation, dose, overall treatment time, previous endocrine treatment, and transuretral resection was not significant for disease-free survival (alive and disease-free) and other endpoints. CONCLUSION: There was no difference between the French series (1975-1982 and 1983-1988). The results of the literature are comparable to ours. As far as prognostic factors are concerned, this report provides evidence that the explainable variables which influence survival depend on the tumor and patient status.
Between 1959 and 1974, two hundred and ninety six carcinomas of the nasopharynx were seen at the Institut Gustave-Roussy, in adults. 78% were in man. The most frequently encountered were undifferentiated or poorly differentiated forms, 76% of cases. 38% only of the patients had their birthplace in France. On the first examination 36% of the cases had a T4 tumour, 50% had fixed cervical lymph nodes and 77% had distant metastases. 30% of the cases could not be treated following a protocol attempting complete cure. Since 1970 the Iridium method of irradiation is not used in T1 and T2 cases and all were treated by high voltage methods with eventual complementary surgical treatment for persistent nodes. The survival rate at 5 years is 30% for the whole group and 37% for the determinated group. Failures were encountered by local recurrence present in 58% of those dying of the disease and distant metastases were found in 37%. 20% of the patients died from distant metastases without local and regional lymph node recurrences. Unfavourable prognostic factors are initial involvement in bone and the differentiated histological type. It was noteworthy that associated multiple cancers were rare.
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